The definitive guide for identifying fungi from clinical specimens

With a new team of authors, Larone's Medically Important Fungi, Seventh Edition, continues the longstanding tradition of high-quality content to expand your knowledge and support your work in clinical mycology by:

Providing detailed descriptions of the major mycoses as viewed in patients' specimens by direct microscopic examination of stained slides
Offering a logical step-by-step process for identification of cultured organisms, utilizing detailed descriptions, images, pointers on organisms' similarities and distinctions, and selected references for further information
Covering more than 150 of the fungi most commonly encountered in the clinical mycology laboratory, including new entries for Emergomyces, Metarhizium anisopliae, Rasamsonia argillacea, Rhinocladiella mackenziei, Schizophyllum commune, and Thermothelomyces thermophilus
Presenting details on each organism's pathogenicity, growth characteristics, relevant biochemical reactions, and microscopic morphology, illustrated with photomicrographs, unique and elegant drawings, and color photos of colony morphology and various test results
Explaining changes in fungal taxonomy and nomenclature that are due to information acquired through molecular taxonomic studies of evolutionary fungal relationships
Providing basic information on molecular diagnostic methods, e.g., nucleic acid amplification and sequencing, MALDI-TOF mass spectrometry, and other commercial platforms
Including an extensive section of easy-to-follow lab protocols, a comprehensive list of media and stain procedures, guidance on collection and preparation of patient specimens, and an illustrated glossary
With Larone's Medically Important Fungi: A Guide to Identification, both novices and experienced professionals in clinical microbiology laboratories can confidently identify commonly encountered fungi.

ABOUT THE AUTHOR

Lars F. Westblade, PhD, D(ABMM) is the Director of the Clinical Microbiology Service at NewYork-Presbyterian/Weill Cornell Medical Center and Associate Professor at Weill Cornell Medicine with a primary appointment in the Department of Pathology and Laboratory Medicine and a secondary appointment in the Division of Infectious Diseases, Department of Medicine. He earned his doctoral degree from the University of Birmingham in the United Kingdom, and completed a fellowship in medical and public health laboratory microbiology at Washington University School of Medicine in St. Louis.

Eileen M. Burd, PhD, D(ABMM) is the Director of the Clinical Microbiology Laboratory at Emory University Hospital and Professor at Emory University School of Medicine with a primary appointment in the Department of Pathology and Laboratory Medicine and a secondary appointment in the Department of Medicine, Division of Infectious Diseases. She earned her doctoral degree from the Medical College of Wisconsin in Milwaukee and was the Division Head of Microbiology at Henry Ford Hospital in Detroit, Michigan prior to joining the faculty at Emory University in 2007.

Shawn R. Lockhart, PhD, D(ABBM) FAAM is the Senior Clinical Laboratory Advisor in the Mycotic Diseases Branch at the Centers for Disease Control and Prevention. He earned his doctoral degree from the University of Kentucky and completed his clinical microbiology fellowship at the University of Iowa Hospitals and Clinics. He directs the CDC training course in mold identification.

Gary W. Procop, MD, MS is the CEO of the American Board of Pathology and Professor of Pathology at the Cleveland Clinic Lerner School of Medicine. He remains a Consulting Staff for the Institute of Pathology and Laboratory Medicine, where he served as Medical Director for the Mycology Laboratory for more than two decades. He earned his doctoral degree from the Marshall University School of Medicine. His residency in anatomic and clinical pathology was completed at Duke University and his medical microbiology fellowship at the Mayo Clinic.


List of Tables

Preface to the Seventh Edition

Preface to the First Edition

Acknowledgments

About the Authors

Basics

How To Use the Guide

Use of Reference Laboratories and Regulations for Transport

Safety Precautions

Taxonomy and Nomenclature

PART I

Direct Microscopic Examination of Clinical Specimens
Introduction
Histological Terminology
Tissue Reactions to Fungal Infections
Stains
TABLE 1.1 Histochemical stains for fungi and/or filamentous bacteria in tissue

Guide to Interpretation of Direct Microscopic Examination
Detailed Descriptions
Actinomycosis
Mycetoma (Actinomycotic or Eumycotic)
Nocardiosis
Mucormycosis (Zygomycosis)
Aspergillosis
Miscellaneous Hyalohyphomycoses (Other than Aspergillosis)
Dermatophytosis (Tinea, Ringworm)
Tinea versicolor
Tinea nigra
Phaeohyphomycosis
Chromoblastomycosis
Sporotrichosis
Histoplasmosis
Emergomycosis
Talaromycosis (Penicilliosis)
Blastomycosis
Paracoccidioidomycosis
Lobomycosis
Candidiasis
Trichosporonosis
Cryptococcosis
Pneumocystosis
Protothecosis
Coccidioidomycosis
Rhinosporidiosis
Adiaspiromycosis
PART II

Identification of Fungi in Culture
Guide to Identification of Fungi in Culture
Detailed Descriptions
Filamentous Bacteria
Introduction to Filamentous Bacteria
TABLE 2.1 Differentiation of filamentous aerobic actinomycetes encountered in clinical specimens

Nocardia spp.
Streptomyces spp.
Actinomadura spp.
Nocardiopsis dassonvillei
Yeasts and Yeastlike Organisms
Introduction to Yeasts and Yeastlike Organisms
Candida albicans
TABLE 2.2 Characteristics of the genera of clinically encountered yeasts and yeastlike organisms

Candida dubliniensis
TABLE 2.3 Characteristics of Candida spp. most commonly encountered in the clinical laboratory

TABLE 2.4 Characteristics that assist in differentiating Candida dubliniensis from Candida albicans

Candida tropicalis
Candida parapsilosis species complex
Candida lusitaniae
Candida krusei
TABLE 2.5 Differentiating characteristics of Geotrichum capitatum (formerly Blastoschizomyces capitatus) versus Candida krusei

TABLE 2.6 Differentiating characteristics of Candida krusei, Candida inconspicua, and Candida norvegensis

Candida kefyr
Candida rugosa species complex
Candida guilliermondii species complex
Thermally Monomorphic Moulds
Mucormycetes
Introduction to Mucormycetes
TABLE 2.11 Differential characteristics of similar organisms in the class Mucormycetes

TABLE 2.12 Differential characteristics of the clinically encountered Rhizopus spp.

Rhizopus spp.
Mucor spp.
Rhizomucor spp.
Lichtheimia corymbifera species complex
Apophysomyces elegans species complex
Saksenaea vasiformis
Cokeromyces recurvatus
Cunninghamella bertholletiae
Syncephalastrum racemosum
Basidiobolus spp.
Dermatophytes
Introduction to Dermatophytes
Latin Terms for Dermatophyte Infections
Microsporum audouinii
Microsporum canis
Paraphyton cookei species complex (formerly Microsporum cookei species complex)
Nannizzia gypsea species complex (formerly Microsporum gypseum species complex)
Lophophyton gallinae (formerly Microsporum gallinae zoophilic form and Microsporum vanbreuseghemii geophilic form )
Nannizzia nana (formerly Microsporum nanum)
Microsporum ferrugineum
Hyaline Hyphomycetes
Introduction to Hyaline Hyphomycetes
Fungi in Which Arthroconidia Predominate
TABLE 2.21 Differential characteristics of fungi in which arthroconidia predominate

Malbranchea spp.
Pseudogymnoascus pannorum (formerly Geomyces pannorum)
Arthrographis kalrae
Hormographiella aspergillata
Common Species of Aspergillus
The genus Aspergillus
Aspergillus fumigatus species complex
Aspergillus niger species complex
Aspergillus flavus species complex
PART III

Basics of Molecular Methods for Fungal Identification
Introduction
Fungal Targets
TABLE 3.1 Frequently used fungal gene targets and primers for sequence-based species identification

TABLE 3.2 Examples of fungal gene targets and primers for multilocus sequence-based species identification

Classic Molecular Identification Methods
Polymerase Chain Reaction
Non-Sequencing-Based Identification Methods
MALDI-TOF
Mass Spectrometry
Signal Amplification Methods
PNA FISH
Nucleic Acid Amplification Methods
T2 Magnetic Resonance
Broad-Panel Molecular Testing and Other Emerging Sample-to-Answer Technologies
Sequencing-Based Identification Methods
Sanger Sequencing
TABLE 3.3 Lane construction for traditional bidirectional Sanger sequencing

Massive Parallel or Next-Generation Sequencing
Applications of DNA Sequencing
Accurate Molecular Identification
TABLE 3.4 Commonly used databases for identification of medically-important fungi

Phylogenetic Analysis
Organism Typing
Detection of Genetic Determinants of Resistance
PART IV

Laboratory Technique
Laboratory Procedures
Collection and Preparation of Specimens
TABLE 4.1 Common clinical sites for laboratory recovery of pathogenic fungi

Methods for Direct Microscopic Examination of Specimens
Primary Isolation
TABLE 4.2 Media for primary isolation of fungi

Macroscopic Examination of Cultures
Microscopic Examination of Growth
Procedure for Identification of Yeasts
Isolation of Yeast When Mixed with Bacteria
Germ Tube Test for the Presumptive Identification of Candida albicans
Rapid Enzyme Tests for the Presumptive Identification of Candida albicans
Caffeic Acid Disk Test
Olive Oil Disks for Culturing Malassezia spp.
Conversion of Thermally Dimorphic Fungi in Culture
Sporulation Inducement Method for Apophysomyces and Saksenaea
In vitro Hair Perforation Test (for Differentiation of Trichophyton mentagrophytes and Trichophyton rubrum)
Temperature Tolerance Testing
Maintenance of Stock Fungal Cultures
Controlling Mites
Staining Methods
Acid-Fast
Modified Kinyoun Stain for Nocardia spp.
Acid-Fast Stain for Ascospores
Ascospore Stain
Calcofluor White Stain
Giemsa Stain
Gomori Methenamine Silver (GMS) Stain
Gram Stain (Hucker Modification)
Lactophenol Cotton Blue
Lactophenol Cotton Blue with Polyvinyl Alcohol (PVA) (Huber's PVA Mounting Medium, Modified)
Rehydration of Paraffin-Embedded Tissue (Deparaffination)
Media
Ascospore Media
Assimilation Media (for Yeasts)
Birdseed Agar (Niger Seed Agar; Staib Agar)
Brain Heart Infusion (BHI) Agar
Buffered Charcoal-Yeast Extract (BCYE) Agar
Canavanine Glycine Bromothymol Blue (CGB) Agar
Casein Agar
Sabouraud Dextrose Agar with 15% NaCl
Sabouraud Dextrose Broth
Starch Hydrolysis Agar
Trichophyton Agars
Tyrosine Agar
Urea Agar
Water Agar
Image Appendix

Glossary

References Cited

Index